Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Back Mountain Pediatrics

Organization Pediatrics Physician · NPI 1063621233

Back Mountain Pediatrics is a Pediatrics Physician in Dallas, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2007.

Licensed in
PA
In the registry since
2007
Specialties on file
2

Practice location Address checks out

550 Memorial Hwy
Dallas, PA 18612
Phone: (570) 675-7955
Fax: (570) 675-7882
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence MD024845E (PA)
Clinical Medical Laboratory Taxonomy 291U00000X · Licence 022874 (PA)

Record details

NPI number1063621233
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joan Greulick — Owner · (570) 675-7955
NPI enumeratedMay 22, 2007
Last updated in NPPESSeptember 11, 2025
Mailing address550 Memorial Highway, Suite 1, Dallas, PA 18612

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